Piperacillin-tazobactam for the treatment of bloodstream infection caused by extended-spectrum-beta-lactamase-producing Enterobacteriaceae :a systematic review and meta-analysis / 中华传染病杂志

ABSTRACT

Objective To study the difference between piperacillin-tazobactam and other anti-infective agents in the treatment of blood stream infection caused by extended spectrum beta-lactamase (ESBL )-producing Enterobacteriaceae by systematic review and meta-analysis . Methods PubMed , Cochrane library ,Web of Science , CNKI , Weipu DATA , and CPVIP were systematically searched . Literatures were reviewed and data regarding mortality of mono -drug treatment with different antibiotics were collected . All data were pooled using the technique of meta-analysis by Revman 5 .3 , and heterogeneity tests were performed .Results Eleven articles containing 1620 patients were included . Escherichia coli and K lebsiella pneumonia were the main pathogens ,and there were 31 cases caused by Enterobacter cloacae .There was no statistically significant difference in mortality between carbapenems and piperacillin-tazobactam mono-therapy for the empirical treatment (RR = 0 .86 ;95％ CI :0 .62 - 1 .20 , P> 0 .05) or for definitive treatment (RR = 0 .63 ;95％ CI :0 .20 - 1 .97 ,P > 0 .05) .Carbapenems were used as the main antibiotics for definitive treatment as well as empirical treatment . Conclusion Piperacillin-tazobactam treatment is not associated with increased mortality of the patients with ESBL -positive enterobacteria bloodstream infection ,which can be used as an alternative antibiotics .